title: Drug resistance among tuberculosis patients attending diagnostic and treatment centres in Makassar, Indonesia.
abstract: METHODS
  Government tuberculosis (TB) diagnostic and treatment centres, Makassar, Indonesia.
  
  
  OBJECTIVE
  To determine the proportions and patterns of resistance to commonly used TB drugs (isoniazid [INH], rifampicin, ethambutol and streptomycin) among pulmonary TB patients and assess potential risk factors for drug resistance.
  
  
  METHODS
  Cross-sectional study.
  
  
  RESULTS
  Of 657 recruited patients, 234 were culture-positive. Drug susceptibility testing (DST) results were available for 216 patients. Among these, 197 were infected with Mycobacterium tuberculosis complex (145 new and 52 previously treated). Isolates from 89 new (61.4%) and 31 previously treated (59.6%) patients were susceptible to all four drugs. Resistance to INH was high among both patient groups (28.3% of new vs. 34.6% of previously treated). Multidrug-resistant TB (MDR-TB) cases accounted for respectively 4.1% and 19.2% of these patients. Resistance to >2 drugs was high among previously treated patients (19.2%). MDR-TB cases were more likely to have a history of excess alcohol use (adjusted OR 4.01, 95%CI 1.28-12.53) and previous TB treatment (adjusted OR 6.28, 95%CI 2.01-19.64).
  
  
  CONCLUSIONS
  Regardless of previous treatment history, many culture-positive TB patients were infected with INH-resistant isolates, and a significant proportion of previously treated patients were infected with MDR-TB. Treating culture-positive TB patients, especially previously treated patients, based on DST results should therefore be considered.
authors.affiliation: Novartis Institute for Tropical Diseases-Eijkman Institute-Hasanuddin University Clinical Research Initiative, Kemerdekaan, South Sulawesi, Makassar, Indonesia. nasrum.massi@novartis.com
authors.forename: M N
authors.initials: MN
authors.lastname: Massi
authors.forename: S
authors.initials: S
authors.lastname: Wahyuni
authors.forename: H
authors.initials: H
authors.lastname: Halik
authors.forename: I
authors.initials: I
authors.lastname: Yusuf
authors.forename: F J
authors.initials: FJ
authors.lastname: Leong
authors.forename: T
authors.initials: T
authors.lastname: Dick
authors.forename: S
authors.initials: S
authors.lastname: Phyu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D000995:Antitubercular Agents / Q000494:pharmacology* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification; D012307:Risk Factors; D014376:Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents